The identification of Lancefield group B streptococci with immunofluorescence was studied after significant differences between the precipitin and immunofluorescent results were noted. It was found that strains of group B streptococci, unlike groups A, C, and G streptococci, do not reliably react with a fluorescein isothiocyanate-labeled conjugate that contains antibodies mainly against C polysaccharide. It was assumed that the difficulty probably resulted from a blocking of the antigenantibody reaction between the group antigen and its antibody by the S antigen located in the capsule. On the basis of this assumption, a conjugate was prepared that contained antibodies against the various S antigens of group B and it was found to be effective.During a survey to determine the distribution of the serotypes of group A streptococci in West Germany (11), it was found that some non-group A strains that gave strong precipitation reactions with anti-group B serum gave weak immunofluorescence reactions with a sample of the same serum labeled with fluorescein isothiocyanate (FITC). This was just the opposite of the results noted by Kubin, Jelinkova, and Franek (5) in a comparison of precipitation and immunofluorescence methods for typing strains of group B streptococci. They were able to type correctly 90.9% of 152 group B strains with immunofluorescence. With the precipitin reaction, however, they were able to identify only 68.8% of the strains satisfactorily. The need for a clarification of this finding assumed even greater significance when it was noted that Smith (10) did not report a similar discrepancy between the precipitin and immunofluorescence reactions of groups A, C, and G streptococci and that Braunstein and coworkers (1) mentioned no difficulty with the application of immunofluorescence in the identification of group B streptococci. Consequently, when the opportunity arose to receive clinical cultures daily from the Munich-Schwabing Municipal Hospital, it was decided to study the problem. This paper is a report of the study that included the examination of 620 streptococcal cultures that were received during a period of 1year.
MATERIALS AND METHODSStreptococcal groups. Strains 09OR (group B, type la), C-74 (group C), and D 166B (group G) were obtained from Rebecca C. Lancefield, Rockefeller University. The remainder of the major types of group B, H36B (type lb), 18RS (type II), and M216 (type III), were obtained from W. R. Maxted, British Central Public Health Laboratory, London. In addition, a group B, type It strain that was isolated from an abscess was used as a "wild strain" antigen. The group A strain (B196) was isolated by Smith, Heymer, and Haferkamp (12) from the throat of a Bonn schoolchild who had no symptoms of a streptococcal angina.The antigens for immunizing rabbits were prepared by the method of Lancefield (6), with the exception that no attempt was made to destroy the group B type antigens.Production of antisera. The immunization procedure utilized was also that of Lancefield (6). For antisera ...